Hospital audit

HAC Penalty Risk Auditor

HAC Penalty Risk Auditor

FY2026 · structural fragility of Total HAC Scores

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Hospital audit

HOUSTON METHODIST THE WOODLANDS HOSPITAL

TX · Facility ID 670122 · FY2026

Total HAC Score

-0.8967

Percentile

5.8th

Displayed status

No reduction

From CMS Payment Reduction column (file).

Score vs threshold (0.3792)

Score distributionThreshold 0.3792Hospital -0.8967

Hospital score -0.8967. Penalty threshold 0.3792. Distribution of 2929 scored hospitals.

Data completeness

Reported on 6 of 6. Missing measures show N/A with the CMS footnote; footnote 18 values are imputed worst-case, not measured performance.

  • PSI-90z -1.483
  • CLABSIz -0.286
  • CAUTIz -1.172
  • SSIz -0.062
  • CDIz -1.288
  • MRSAz -1.089

Fragility

Each reported measure moves the score by 0.1667 points.

Score swing if each reported measure were at its Z floor versus Z cap, holding other measures fixed
MeasureCurrent ZScore @ floorScore @ capAbs swing
PSI-90controls fate-1.4834-0.8967-0.23100.6657
CAUTI-1.1716-0.9212-0.30380.6175
MRSA-1.0894-0.9581-0.34430.6137
CDI-1.2879-0.9258-0.31660.6092
CLABSI-0.2860-1.0835-0.47570.6078
SSI-0.0621-1.1291-0.52440.6047

Swing is a mechanics illustration: replace one reported Z with that measure’s observed floor or cap while holding others fixed. Ranked by absolute swing.

Peer context

Percentile within TX (255 scored): 9.2th

Score distributionThreshold 0.3792Hospital -0.8967

Hospital score -0.8967. Penalty threshold 0.3792. Distribution of 255 scored hospitals.

Percentile among hospitals with 6 reported measures (1940 scored): 2.6th

Score distributionThreshold 0.3792Hospital -0.8967

Hospital score -0.8967. Penalty threshold 0.3792. Distribution of 1940 scored hospitals.

Plain-language verdict

As scored, the CMS file lists no payment reduction (Total HAC Score -0.8967; threshold 0.3792).

Reported on 6 of 6 measures; each reported measure moves the equal-weighted score by 0.1667 points.

Describes scoring mechanics only. Not medical or legal advice. Any “would / would not” language is an illustration against the published threshold, not a CMS prediction.

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